Migrant and refugee youth’s sexual and reproductive health and rights: decision-making and agency

Abstract

Sexual and reproductive health (SRH) is a human right and crucial to social wellbeing. Yet rights to SRH are unevenly attained, with migrant and refugee youth (MRY) facing challenges in realising rights. Australian MRY have low SRH service use, knowledge and education, and contend with family and cultural stigma. While there is nascent scholarship on MRY’s SRH, there is limited rights-based research. Existing research has largely reported on vulnerabilities and deficits. There is, however, a need to further examine the SRH decision-making of MRY – a need this thesis seeks to meet.

This research used mixed methods to examine the sexual and reproductive health and rights (SRHR) decision-making and agency of MRY, aged 16-26 years, in Sydney, Australia. Two systematic reviews and three primary studies comprise main findings. A mixed methods group concept mapping study examined socioecological factors informing decision-making. SRH knowledge, attitudes, behaviours, and service use were explored using a quantitative survey, with analysis focusing on gender. Qualitative interviews examined decision-making and experiences of young migrant abortion-seekers.

Mixed methods findings revealed emotional, relational factors were equally important as physiological/biomedical factors in MRY decision-making. Despite having negative impacts on decision-making, family and culture were not as important as other factors. Survey findings showed female MRY are significantly more likely to be pressured into sex while males have lower contraceptive awareness, service use and vaccination. Interviews showed myriad factors inform abortion decisions. However, young female migrants are certain and autonomous in their choice. In all studies, MRY reported stigma and low SRH education, yet navigated around these restrictions. Findings indicate policy must go beyond biomedical models of SRH, recognising multiple factors informing MRY decision-making.